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ST HELENA GOVERNMENT TERMS OF REFERENCE FOR PHARMACIST Introduction The island of St Helena, an Overseas Territory of the United Kingdom (UK) is of volcanic origin and covers 47 square miles in the South Atlantic Ocean. St Helena is over 4,000 miles from the UK, 700 miles southeast of Ascension Island, and 1,700 miles from South Africa. The Island’s total population is around 4,000 persons, about 25% of whom live in the capital, Jamestown. The climate is kept mild and equable by the southeast trade winds and temperatures range from 14-32 degrees centigrade in the summer and 14-26 degrees centigrade in winter. The economy is small and is mainly based on offshore employment, agriculture, fishing and more recently a small but growing volume of tourism. Most commodities are imported and St Helena relies heavily on UK Aid to support essential services and livelihoods. St Helena currently has no airfield and therefore the only regular mode of access to the Island is via the Royal Mail Ship (RMS) St Helena, which calls roughly 25 times a year, shuttling between St Helena, Ascension, and Cape Town. On 22 July 2010 the Secretary of State for International Development, Andrew Mitchell, announced the UK Government’s intention to finance a project to build an airport on St Helena subject to four conditions being met. On 3 November 2011 it was announced that the Secretary of State’s conditions had been met, and a contract had been entered into with Basil Read (Pty) Ltd in the amount of £201.5 million for the design and construction of the airport, an additional up to £10 million in shared risk contingency, and £35.1 million for ten years of operation. The airport will greatly improve travel to and from the Island, open up opportunities for sustainable economic regeneration and ultimate financial self-sufficiency for St Helena. The Governor is the most senior official in the St Helena Government (SHG) and he is supported by the three next ranking officials ie the Chief Secretary, the Financial Secretary and the Attorney General. Strategic decisions are in the main taken by the Executive Council which is chaired by the Governor and comprises 5 elected Members of the Legislative Council and the 3 senior SHG officials as ex officio members. The Public Service comprises a number of directorates each headed by a Director reporting either to the Chief Secretary, Financial Secretary or directly to the Governor. Most of the directorates are also required to work with one or more of the 8 Council Committees that comprise elected Members of the Legislative Council. The Directorates are required to provide advice to, and take policy direction from, the relevant Committees. Background St Helena has a 30 bed hospital. Primary care services are provided in James Town Clinic located next to the hospital building - and 5 district clinics as well as in the community. Hospital redevelopment plans are in an advanced stage and are expected to commence early next year. Four medical officers, including one surgeon are working on St Helena and employed by the Directorate of Health and Social Welfare, while the Directorate is currently recruiting 2 more medical officers to enlarge the medical skills set on island. The post of Pharmacist sits within the Directorate of Health and Social Welfare, which is the largest of SHG’s Directorates in terms of employee numbers and recurrent budget. The Directorate’s Pharmacy is the only Pharmacy on the island. Whilst there are retail outlets that sell a small amount of over the counter medications, theses outlets do not employ qualified Pharmacists and so the Health and Social Welfare Directorate Pharmacy is the only place from which prescription medications can be obtained. The Pharmacy is situated in the main administration building of the Health and Social welfare Directorate, in Upper Jamestown, which is adjacent to the island’s only hospital and so the Pharmacist is required to work closely with medical officers and nursing staff in the supply of medications for inpatient use. The Pharmacist will report to the Senior Medical Officer/Clinical Director and will have line management responsibility for 4 locally trained pharmacy staff. Brief Description The Pharmacist will be responsible to promote and ensure safe and cost-effective use of medicines and other medical supplies at primary care settings, in the community and in the hospital on St Helena Summary of Duties 1. The Pharmacist contributes to the St Helena Health and Social Welfare Policy and Strategic Planning goals and objectives, reporting on progress towards these goals in line with contractual requirements, through the Senior Medical Officer/Clinical Director. 2. To prepare, dispense and supervise dispensing (including extemporaneous preparations) prescriptions accurately, safely and in a timely manner ensuring contraindications for specific drugs are considered as per available patient data/records. 3. To generate and issue repeat prescriptions in accordance with hospital policies and standard operating procedures. 4. To ensure accurate and timely updating of patient medication records using the EMIS computer system. 5. To prepare products (eg TPN) aseptically when required. 6. To provide and supervise staff providing counselling to patients taking prescribed medication in order to maximise concordance. 7. To ensure safe and effective prescribing by monitoring prescriptions and providing advice to clinicians on all aspects of medication, including information about sideeffects, harmful interactions with other drugs and the suitability of treatments for patients with particular health conditions. 8. To ensure that appropriate drug stocks are held in the Pharmacy by performing regular stock-checks, monitoring usage and wastage rates and revising stock levels as necessary. 9. To review, supervise and ensure adequate management of drugs and supplies in the hospital and district clinics. 10. To ensure secure and safe storage of medicinal products in accordance with manufacturers guidance and COSHH regulations to ensure freshness, safety and potency. Manage controlled drug stocks in accordance with agreed procedures. 11. To be responsible for the process of compiling and placing orders, receiving deliveries and reconciling invoices and ensuring that annual budget is not exceeded. 12. To maintain and develop pharmacy and dispensary protocols, guidelines and standard operating procedures as necessary to minimise drug related incidents. 13. To ensure evidence-based, cost-effective prescribing practice by maintaining, updating and monitoring compliance with the hospital formulary and other pharmaceutical guidelines, working in collaboration with clinical colleagues. 14. To keep abreast of, and evaluate, new medications and to advise on their adoption. 15. To review/prepare/update essential drug lists for St Helena, based on latest version of British National Formulary with adaptations as required for St Helena demographic and health statistics and isolated setting. 16. To participate in clinical governance meetings and risk management activities, including providing input into prescribing audits, clinical guideline development, development patient directives/leaflets and staff training. 17. To comply with the local legislative and regulatory framework and Directorate policies and procedures in regard to control and management of medicines, including the disposal of out-of-date drugs. 18. To collate and submit accurate, timely statistical information in accordance with the requirements of colleagues and external bodies. 19. To be responsible for own personal professional development and keep abreast of new clinical practices by use of relevant reading, e-learning, attendance at in-service training etc. 20. To comply with all SHG and Health and Social Welfare Directorate policies, procedures and staff instructions, in particular in regards to health and safety and equal opportunities. 21. To be available for out of hours requests for advice on medication and provision of emergency drugs and medical gases. 22. To provide on-the-job guidance and coaching of staff and undertake annual and midyear staff appraisals for all staff in the Pharmacy and discuss/recommend and identify job and career related professional development opportunities. 23. To review drug procurement/management policies and assist Directorate of Health and Social Welfare with exploring cost-effective alternatives, which may include an NHS link and exploring divestment/outsourcing opportunities for selected pharmacy services. 24. To organise training and participate in continuous professional development events for pharmacy staff, nurses, student nurses and doctors as relevant/required. 25. To undertake other duties appropriate to the post as required by the Director of Health and Social Welfare / Senior Medical Officer/Clinical Director Note: This summary of duties is intended only as a guide to the duties involved and may be modified to meet changing needs. The employee will be expected to be flexible in his role and responsibilities to enable the health services team to work together most effectively. Reporting The employee will report directly to the Senior Medical Officer/Clinical Director. The employee should submit the following reports: a) A monthly report on day-to-day activities of the Pharmacy, including statistical data on drug usage. Report to be submitted before the sixth working day of each month and should detail activity during preceding month. b) Quarterly progress reports relating to activities included in the Directorate’s Strategic Plan c) An annual report: an overview of the activities during the previous year and progress towards achieving strategic goals, including statistical data on drug/supply usage and any recommendations to further improve service provision. d) An end of contract completion report: a synopsis of activities during contract, outcomes of activities and analysis of extent to which objectives have been reached. A draft version of the report must be submitted before departure from the island and the final version submitted within two weeks of return to country of origin. Qualifications, Experience and Skills Required Essential Pharmacy degree Registration with the General Pharmaceutical Council (previously the Royal Pharmaceutical Society of Great Britain) or other equivalent international professional registering body At least three years’ experience post registration Good communication, team and interpersonal skills Able to work autonomously and manage own workload Computer literate Knowledge and experience of electronic stock control Desirable Experience in different sectors of pharmacy including both hospital and community Experience in aseptic dispensing. Experience of audit and prescribing practices and medicines management Experience of developing and implementing pharmacy protocols/guidelines/SOPs and formularies Contracting The contract will initially be for a duration of one year with the possibility of an extension. Anticipated starting date is March 2012.